Read twice and referred to the Committee on Finance.
The bill amends Title XIX of the Social Security Act to permanently restore a federal Medicaid disproportionate share hospital (DSH) allotment to the State of Tennessee beginning in fiscal year 2026. It sets Tennessee’s FY2026 allotment equal to the DSH allotment Tennessee had for FY2015 (under paragraph (6)(A)(vi)) and then increases that amount in subsequent years by the percentage change in the Consumer Price Index for All Urban Consumers (CPI-U).
Scale and permanence of federal spending: liberals and centrists generally accept targeted federal support; conservatives see an unacceptable expansion of federal entitlement spending.
Relative to its intended legislative type, this bill is a narrowly focused substantive amendment that prescribes a permanent DSH allotment for Tennessee by inserting a specific subparagraph into the Social Security Act.
The bill amends Title XIX of the Social Security Act to permanently restore a federal Medicaid disproportionate share hospital (DSH) allotment to the State of Tennessee beginning in fiscal year 2026.
It sets Tennessee’s FY2026 allotment equal to the DSH allotment Tennessee had for FY2015 (under paragraph (6)(A)(vi)) and then increases that amount in subsequent years by the percentage change in the Consumer Price Index for All Urban Consumers (CPI-U).
For fiscal years after 2026 Tennessee is to be treated as a “low DSH” state for purposes of future DSH allotment increases, so its allotment will grow in the same manner as other low-DSH states.
On content alone the bill is narrow and administratively straightforward, which helps its chances; however, it creates a permanent, indexed federal funding benefit for a single state without offsets or sunset language, making it vulnerable to objections about fiscal cost and precedent. Such geographically targeted entitlement changes more often succeed when bundled into larger bipartisan deals or when accompanied by offsets or wider reforms; as a standalone bill its likelihood of becoming law appears low to modest.
Relative to its intended legislative type, this bill is a narrowly focused substantive amendment that prescribes a permanent DSH allotment for Tennessee by inserting a specific subparagraph into the Social Security Act. It gives a concrete baseline and annual update rule and integrates with existing statutory allocation mechanics.
Scale and permanence of federal spending: liberals and centrists generally accept targeted federal support; conservatives see an unacceptable expansion of federal entitlement spending.
These are examples from the analysis, not a ranked list of the most-affected groups.
Scale and permanence of federal spending: liberals and centrists generally accept targeted federal support; conservatives see an unacceptable expansion of federal entitlement spending.
Overall supportive.
This persona would view the bill as restoring and protecting federal support for hospitals that serve high numbers of low-income and uninsured patients in Tennessee, including rural and safety-net hospitals.
They would appreciate the permanent nature of the allotment and the CPI indexing as protections against real-dollar erosion.
Cautiously favorable but pragmatic.
This persona would see a clear targeted federal policy to stabilize hospitals in Tennessee as meritorious, especially if closures or strained facilities are documented.
At the same time they would be concerned about the fiscal cost, lack of offsets, and the precedent of a state‑specific permanent entitlement.
Likely opposed.
This persona would view the bill as an increase in federal spending targeted to a single state, bypassing state flexibility and potentially rewarding policy choices made at the state level.
They would object to creating a permanent entitlement increase without offsets, to CPI indexing that guarantees growth, and to overriding a state demonstration (TennCare) negotiated under federal rules.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
On content alone the bill is narrow and administratively straightforward, which helps its chances; however, it creates a permanent, indexed federal funding benefit for a single state without offsets or sunset language, making it vulnerable to objections about fiscal cost and precedent. Such geographically targeted entitlement changes more often succeed when bundled into larger bipartisan deals or when accompanied by offsets or wider reforms; as a standalone bill its likelihood of becoming law appears low to modest.
The bill has not accumulated any surfaced votes yet.
Scale and permanence of federal spending: liberals and centrists generally accept targeted federal support; conservatives see an unacceptab…
On content alone the bill is narrow and administratively straightforward, which helps its chances; however, it creates a permanent, indexed…
Relative to its intended legislative type, this bill is a narrowly focused substantive amendment that prescribes a permanent DSH allotment for Tennessee by inserting a specific subparagraph into the Social Security Act.…
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